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Is Indiana’s Healthy Hoosiers program a model that could work in other states?

Background Information

Debate Question:This is what a short summary question would look like.

In 2015, Indiana introduced the latest version of its Healthy Indiana Plan (HIP), replacing traditional Medicaid in the state. The program, which required waivers from the federal government, is designed to provide coverage for residents at or near the poverty line. HIP uses a consumer-driven design and relies on high-deductible health plans (HDHPs) paired with health savings accounts (HSAs) in order to engage beneficiaries in their healthcare purchasing and use.

Several aspects of the program, including premiums for residents with no income, seem to have kept some people from enrolling or getting needed healthcare. Participants in have found it confusing to sign up and use. These problems may particularly affect the most vulnerable.

Zetema Panelist Against

Good Point
+1

The program is designed to promote personal responsibility to contain costs, to encourage preventive care, and to reduce use of unneeded care. Participants pay an income-based contribution into a health savings account each month.

Zetema Panelist In Favor

+1 Good Point

Fewer than half of HIP beneficiaries were even aware that they had HSAs, so it’s unlikely that these will affect their behavior. Many find it offensive to argue that working-class people working paycheck-to-paycheck are not invested in spending their health care dollars wisely.

Zetema Panelist Against

Good Point
+1

Beneficiaries report a high rate of satisfaction with HIP. The majority elected to pay to receive the higher level of benefits.

Zetema Panelist In Favor

+1 Good Point

Physicians and potential beneficiaries report a high level of frustration with enrollment.

Zetema Panelist Against

Good Point
+1

HIP is designed to offer similar benefits and responsibilities to those in private health plans, which is fair to all and instills a sense of dignity to poor people.

Zetema Panelist In Favor

+1 Good Point

It’s not realistic to expect people with very low or no income to make the same tradeoffs regarding healthcare that those with more money can make.

Zetema Panelist Against

Good Point
+1

The early results seem to indicate that HIP, despite some bureaucratic problems, has successfully expanded coverage while encouraging beneficiaries to take more responsibility for their healthcare funding and use.

Zetema Panelist In Favor

+1 Good Point

Some have fared worse than they had under traditional Medicaid. It’s too early to evaluate the program overall. But we know that all the funding for this expanded coverage came from the Affordable Care Act, so it’s at risk if that law is repealed.